| NPI | 1396364899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAURA MAUPIN Owner 850-905-0110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 207RP1001X Internal Medicine, Pulmonary Disease | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2020-04-14 |
| Last Update Date | 2020-09-04 |